Inflammation As Cause Of Pots/ans Dysfunction?

[firewatcher]

Hmmm:

Clin Auton Res. 2010 May 1. [Epub ahead of print]

Does an acute inflammatory response temporarily attenuate parasympathetic reactivation?

Jae SY, Heffernan KS, Park SH, Jung SH, Yoon ES, Kim EJ, Ahn ES, Fernhall B.

Department of Sports Informatics, The Health and Integrative Physiology Laboratory, University of Seoul, 90 Jeonnong-dong, Dongdaemun-gu, Seoul, 130-743, South Korea, syjae@uos.ac.kr.

Abstract

PURPOSE: Although observational studies suggest that inflammatory markers are associated with autonomic nervous system function, the causal relationship of this is not clear. We tested the hypothesis that acute inflammation will temporarily attenuate vagal reactivation as measured by heart rate recovery after exercise. METHODS: In this double-blind randomized study, 24 healthy subjects were assigned to receive either an influenza vaccine (n = 15) as a model to generate a systemic inflammatory response or a sham vaccine (n = 9). Heart rate recovery after exercise testing was used as an index of parasympathetic nervous function and was calculated as the difference between maximal heart rate during the test and heart rate 1 and 2 min after cessation of exercise. Both blood analysis and treadmill exercise stress tests were conducted before and 48 h after each vaccination. RESULTS: Inflammatory marker, log C-reactive protein (1.9 +/- 1.2 to 2.8 +/- 1.4, p < 0.05) was significantly increased after the influenza vaccine. Heart rate recovery 1 was significantly attenuated 48 h after the influenza vaccination (23.4 +/- 6.4 to 20.5 +/- 4.9, p < 0.05) but not sham vaccination. CONCLUSIONS: These findings show that acute inflammation is associated with a temporary deterioration in cardiac autonomic nervous system function in healthy subjects.

PMID: 20437076

May have implications in both the pathology and continuation of our symptoms...

[Noreen]

Logic would be on your side. However, I always have the C-reactive protein done as part of my rheumy panel and it isn't elevated. That would be a good thing if the drugs were working and no rheumatological disease activity was occurring. However, there is still something affecting the autonomic system that doesn't show up in the usual 2 dozen vials drawn 2 to 3 times a year for testing.

Anyone else have different reports with CRP testing ongoing over the course of their disease(s)?

[rach73]

Hi,

this is very interesting as my CRP levels are always elevated. Last year they were recorded at 33, the highest level I have had. Due to this they did an ANA test but it was negative. No cause was found for the elevation.

Im having this repeated next week and will be interested to see what the levels are this time.

Rach

[ramakentesh]

Nearly all the inflammatory markers are vasoactive - they either modulate sympathetic or parasympathetic activity or cause vasoconstriction/dilation so its not really surprising - infact J Stewart did an article early on suggesting that in most POTS patients there was signs of persistant inflammation.

In my case I also have Ankylosing Spondylitis and im inflammed as!! Got POTs when I got AS so this angle is something ive looked into extensively.

Inflammation can also cause abherant DNA methylation. C-reactive Protein directly effects angiotensin II catabolism, which can result in increased angiotensin II, reduced neuronal nitric oxide and classic low flow POTS. TNF alpha is a potent vasoconstrictor. Most inflammatory peptides if released in the cerebral vascular cause dilation and abnormnal cerebral autoregulation (as found in 50% of POTS patients).

Abnormal autonomic function is often found in AS and RA patients.

[rach73]

Hi,

Massive thank you for that. My sister has has ME for most of her life and is chronically ill with it. The thing is now many of our symptoms are shared- autonomic ones, its really bizarre.

My sister always has positive markers for high inflammtion, so its extremely interesting for me to read this. She is currently doing the rounds with many Drs at the moment due to her symptoms becoming so much worse. She has fast and slow heart rates and she told me today that when she stands up she sees stars. So it has become very interesting indeed lately.

We hope if one of us gets diagnosed with something it may help the other!

Sorry to ask but can you try and give me a more basic break down of the low flow pots. I have read loads of stuff on here, but due to me A) being thick or not fully functioning on all fronts I have had a little difficulty understanding this.

So thank you again

Rach

[ramakentesh]

Does she have POTS or NMH? ME is often a diagnosis of exclusion - in that everything else has been excluded so the CFS / ME label applies.

[Stormie74]

I ALWAYS have a problem with inflammation. Always. Doctors are always alarmed by my high C-reactive Protein results. In fact, I have an appointment tomorrow to find out what it is now... just had it taken a week ago. Interesting article!

[rach73]

Hi,

she was diagnosed with ME over twenty years ago, when she was 14. She became ill after a bad bout of flu. However she was always getting strange illnesses as a child that nobody could figure out why she was getting them.

She has had MRI scans of her brain which revealed no brain stem leisons which show on a lot of ME patients. She has never had any formal ME testing. This diagnosis was reached after testing revealed nothing other than a few antibodies for toxicara and coxsakie virus. (sorry if I have spelt those wrong). After that she recieved no follow up. Despite the fact she was having seizures, and became doubly incontinent.

My concern has always been is it ME or actually something else? Its only now that she is getting further investigations as her condition has become much worse. She has no diagnosis of POTS or NMH. She is now back under a neurologist, endocrinologist and a few others. She has been also referred to an ME specialist.

Its now only after spending time on this forum and doing a bit of research that I have realised that she is suffering with some sort of autonomic dysfunction.

From birth she has had issues with thermoregulation. This is something I have developed in the last few years. Everyone is in t-shirts today, I have a thermal vest on, a t-shirt, a sweatshirt, gloves and hat on. My finger nails are blue because I am so cold. We both have low body temperatures ranging from 35.5-36.3 max. Both suffer from night sweats, nausea, vomiting, gi problems. Both have problems with fast and slow heart rates. Memory loss, numbness and pins and needles in various parts of our bodies. Both of us actually only feel ok when laying flat. Both have fatigue and weakness. I am the only one with a droopy face and eye. Both of us need wheel chairs to get around and we both suffer with joint/ bone pain. The longer we are both ill the more our symptoms seem to be the same. As we are in different parts of the country we are seen by different people.

She has inflammation markers in her blood, as do I. Though both of us are negative on ANA, tests. Clearly something is going on. Thats why I was so very interested when I saw the article you posted.

Sorry I seem to have hijacked your thread. Im really sorry about that. Its just it really is very interesting to me.

Rach

[summer]

Sorry to ask but can you try and give me a more basic break down of the low flow pots. I have read loads of stuff on here, but due to me A) being thick or not fully functioning on all fronts I have had a little difficulty understanding this.

Same here. Even after reading lots on low flow pots, I have difficulty understanding it and how the periferal vasoconstriction causes the increased HR.

[ramakentesh]

In Low flow POTS there is low blood flow to the extremities - less blood going to the hands, arms, feet and legs. This is caused by increased peripheral resistance or vasoconstriction of the arms and legs. This also means the leg-based skeletal muscle pump is less effective because there is less blood flow there.

But the main issues in Low Flow POTS are excessive vasoconstriction everywhere - so if the arteries are always vasoconstricted then there is less blood available to vein reservoirs that feed the heart its blood. THis results in reduced stroke volume.

Reduced stroke volume and thoratic hypovolumia result (less blood feed to the heart) and reduced blood flow to the brain is the end result.

The tachycardia in low flow POTS is adrenergically mediated - its not just a reflex mechanism to increase blood flow to the brain, its also caused by oversensisation of the heart to norepinephrine and epinephrine.

Im in a hurry so I can go into much detail . if this doesnt make sense (quite possible) ill try better later in the week.

[rach73]

Thank you so much for that.

Rach

[juliegee]

Just as an aside- my son's ped from Hopkins has had good success treating his patients with antibiotics to treat underlying chronic inflammation. He's convinced that some of these kids actually had Lyme. But others improve for no apparent reason other than the inflammation is being addressed.

Julie

[Aquadiva]

Interestingly enough, my daughter can have severe inflammation and have NO elevated inflammatory markers. She has UC, and the labs have NEVER told us she had inflammation, her CRP and SED rate have been normal. In fact, in the beginning, they told us the GOOD NEWS was that she didn't have inflammatory bowel disease. That was going by her labs. Never mind she had bloody stools, fatigue, and anemia. They said that it was likely something she picked up such as a bacteria or something even though stool studies showed no bacteria. Only after things got really bad did she get referred to GI and they did a scope/biopsies and tested to be ANA positive along with inflammatory bowel disease.

She is never even "normal" abnormally!!

I would be VERY intersted to see if an antibiotic could help her feel better. But, with UC we also need to be cautious with antibiotics.

[TXPOTS]

In Low flow POTS there is low blood flow to the extremities - less blood going to the hands, arms, feet and legs. This is caused by increased peripheral resistance or vasoconstriction of the arms and legs. This also means the leg-based skeletal muscle pump is less effective because there is less blood flow there.

But the main issues in Low Flow POTS are excessive vasoconstriction everywhere - so if the arteries are always vasoconstricted then there is less blood available to vein reservoirs that feed the heart its blood. THis results in reduced stroke volume.

Reduced stroke volume and thoratic hypovolumia result (less blood feed to the heart) and reduced blood flow to the brain is the end result.

The tachycardia in low flow POTS is adrenergically mediated - its not just a reflex mechanism to increase blood flow to the brain, its also caused by oversensisation of the heart to norepinephrine and epinephrine.

Im in a hurry so I can go into much detail . if this doesnt make sense (quite possible) ill try better later in the week.

Great explanation. It seems the pharmacologic options for high flow versus low flow are polar opposites. No wonder so many patients with POTS have bad drug reactions. I, myself, have low flow POTS, and we are exploring additional drug treatment. Obviously, Midodrine was a complete disaster. I am actually curious about labetalol since it is a dual beta and alpha antagonist. I notice Dr. Grubb included it on one of his treatment algorithms.

[mvdula]

Can anyone give any symptom markers for low-flow vs. high-flow or normal-flow POTS? I really don't think I understand all the mechanisms very well.

Wondering because dizziness, fainting and brain fog are not symptoms for me. Walking is a help to my symptoms. I also think Vit D is a help for me, but still testing that out.

I do not tolerate strenous activity or much aerobic activity, bending over too much, or heat. If I do those things (and occasionally unprovoked), I will end up with a nasty 'episode' like racing/pounding hr, weakness, hot, or various other nasty things...for various periods of time....up to 2 hrs or so max. Some of these episodes have been very terrifying, like feeling on the verge of death for 1+ hrs; some have been tolerable but weird....like last night's thing where I get a knot below (not under) my ribcage, in the middle, maybe stomach? but I don't think so, maybe diaphragm....that will not go away - even had it this morn, feel like I want to push on that area - but it was actually painful when I did this morn, now it is gone....sorry for rambling, I hate odd symptoms that I cannot understand/explain.

[juliegee]

Interestingly enough, my daughter can have severe inflammation and have NO elevated inflammatory markers. She has UC, and the labs have NEVER told us she had inflammation, her CRP and SED rate have been normal. In fact, in the beginning, they told us the GOOD NEWS was that she didn't have inflammatory bowel disease. That was going by her labs. Never mind she had bloody stools, fatigue, and anemia. They said that it was likely something she picked up such as a bacteria or something even though stool studies showed no bacteria. Only after things got really bad did she get referred to GI and they did a scope/biopsies and tested to be ANA positive along with inflammatory bowel disease.

She is never even "normal" abnormally!!

I would be VERY intersted to see if an antibiotic could help her feel better. But, with UC we also need to be cautious with antibiotics.

Hey Aquadiva-

Mack has severe GI issues too (not UC): severe GERD and small bowel dysmotility. He takes lots of meds for the GI stuff. Most importantly, he takes a hefty dose of probiotics (2 Culturelle) daily to negate any negative side effects from the antibiotics. Probiotics have to be taken apart from the antibiotics. So, he takes one 50mg doxycycline in the AM, probiotics when he gets home from school, and another doxycycline in the PM. So far, no negative reaction for the antibiotic....not sure how much it's helping... He's "stable-ish" for him during a very difficult time at school- finals, etc.. Fatigue continues to be his biggest issue.

The way I understand it, antibiotics kill off good bacteria in the GI tract. In order to have a healthy gut, you need a balance of good and bad bacteria. Probiotics add the good bacteria back as long as they are taken several hours after the antibiotic. Mack used to have bacterial overgrowths in his GI tract, that's when the bad bacteria takes over. Since taking a daily Culturelle (2 since the ant-B's) no more bacterial overgrowths.

Just a thought in case her doc ever wants to try antibiotics.

BTW, I have every sign of chronic inflammation and no laboratory markers are abnormal for me either.

Julie

[Aquadiva]

Interestingly enough, my daughter can have severe inflammation and have NO elevated inflammatory markers. She has UC, and the labs have NEVER told us she had inflammation, her CRP and SED rate have been normal. In fact, in the beginning, they told us the GOOD NEWS was that she didn't have inflammatory bowel disease. That was going by her labs. Never mind she had bloody stools, fatigue, and anemia. They said that it was likely something she picked up such as a bacteria or something even though stool studies showed no bacteria. Only after things got really bad did she get referred to GI and they did a scope/biopsies and tested to be ANA positive along with inflammatory bowel disease.

She is never even "normal" abnormally!!

I would be VERY intersted to see if an antibiotic could help her feel better. But, with UC we also need to be cautious with antibiotics.

Hey Aquadiva-

Mack has severe GI issues too (not UC): severe GERD and small bowel dysmotility. He takes lots of meds for the GI stuff. Most importantly, he takes a hefty dose of probiotics (2 Culturelle) daily to negate any negative side effects from the antibiotics. Probiotics have to be taken apart from the antibiotics. So, he takes one 50mg doxycycline in the AM, probiotics when he gets home from school, and another doxycycline in the PM. So far, no negative reaction for the antibiotic....not sure how much it's helping... He's "stable-ish" for him during a very difficult time at school- finals, etc.. Fatigue continues to be his biggest issue.

The way I understand it, antibiotics kill off good bacteria in the GI tract. In order to have a healthy gut, you need a balance of good and bad bacteria. Probiotics add the good bacteria back as long as they are taken several hours after the antibiotic. Mack used to have bacterial overgrowths in his GI tract, that's when the bad bacteria takes over. Since taking a daily Culturelle (2 since the ant-B's) no more bacterial overgrowths.

Just a thought in case her doc ever wants to try antibiotics.

BTW, I have every sign of chronic inflammation and no laboratory markers are abnormal for me either.

Julie

Thanks Julie. She has been on antibiotics since dx without issues for illness and she takes doxicycline too, twice a day without problems. I believe some antibiotics are worse than others. But, she had C-Diff when she was hospitalized (after a round of antibiotics) and I believe once you have had it, it can come back easier, especially after antibiotic use. C-Diff can be VERY nasty and hard to get rid of. With her body already wanting to attack her colon with "normal" bacteria levels, I get a bit nervous whenever she is on them. She has been in very bad shape and we don't ever care to go back! But, if antibiotics were shown to improve POTS symptoms, I would seriously consider!

I know of a lot of people that are on Culturelle and similar probiotics for UC. We have just never tried them as she was so bad when it all first started, and went with the strong meds and they are working wonderfully. Wish there was something we could find that would work as well on her POTS!! She has done yogurt before when on antibiotics, but it probably wasn't enough to do much.

I hope you have a doctor that understands you are "special". It drives me crazy when all they look at are the numbers. Luckily, her GI is WONDERFUL that way. She has "seen" it with her own eyes. She is amazed at how good she can appear on the outside and what a mess she can be on the inside at the same time. Unfortunately, though, because we can't rely on the numbers to tell us anything it means frequent scopes, which are no fun. I really feel that is why the rheumatologist didn't take her seriously--because all her inflammation #'s were fine. Then WHY all the pain and swelling????

It would be interesting in deed to see more on inflammation and POTS!

[issie]

I'm no expert on this subject but I have to comment on this because of my past history. Antibiotics, to my knowledge, are not for inflammation. NSAIDS are for that. Because of being given too many antibiotics, I developed ulcerative colitis. This is severe ulcers, bleeding and inflamation of the colon. I had to go to the bathroom every 5 minutes and it became the dry heaves (only in the opposite end.) The doctor said that most people die within 2 days of having it as bad as I did. It causes a severe imbalance of the intestional flora (good bacterria). When this happened due to the antibiotics, I had to do chemo therapy twice, to kill all the bad bacteria that the antibiotics caused. I nearly DIED. LITERALLY!!!!!!! It took me years to get the good bacteria balanced and to heal up my colon. I had terrible cramping and spasms and that lasted for years. It scares me that someone would stay on antibiotics thinking they are helping themselves. In my case ---everything got worse.

One way to get the good bacteria back is the probiotics. Also Kefeir is easy to drink and taste good. Normally, for antibiotics to work, you wouldn't take them at the same time as the probiotics. You could try Collidol Silver, it's supposed to kill bad bacteria. This is controversal though. I know someone who swears they are still alive when issued a death sentence to cancer. But, then there is that guy who turned BLUE from it too.

I hope you really consider what happened to me. Antibiotics aren't always the answer. When you really need them for a life threatening situation, you may have made yourself resistant and then they won't work.

One other thing I've read and heard about is -- Olive Leaf. It is supposed to be a natural antibiotic and has cured malaria when antibiotics haven't. Maybe this might be a better choice.

[juliegee]

I'm no expert on this subject but I have to comment on this because of my past history. Antibiotics, to my knowledge, are not for inflammation. NSAIDS are for that. Because of being given too many antibiotics, I developed ulcerative colitis. This is severe ulcers, bleeding and inflamation of the colon. I had to go to the bathroom every 5 minutes and it became the dry heaves (only in the opposite end.) The doctor said that most people die within 2 days of having it as bad as I did. It causes a severe imbalance of the intestional flora (good bacterria). When this happened due to the antibiotics, I had to do chemo therapy twice, to kill all the bad bacteria that the antibiotics caused. I nearly DIED. LITERALLY!!!!!!! It took me years to get the good bacteria balanced and to heal up my colon. I had terrible cramping and spasms and that lasted for years. It scares me that someone would stay on antibiotics thinking they are helping themselves. In my case ---everything got worse.

One way to get the good bacteria back is the probiotics. Also Kefeir is easy to drink and taste good. Normally, for antibiotics to work, you wouldn't take them at the same time as the probiotics. You could try Collidol Silver, it's supposed to kill bad bacteria. This is controversal though. I know someone who swears they are still alive when issued a death sentence to cancer. But, then there is that guy who turned BLUE from it too.

I hope you really consider what happened to me. Antibiotics aren't always the answer. When you really need them for a life threatening situation, you may have made yourself resistant and then they won't work.

One other thing I've read and heard about is -- Olive Leaf. It is supposed to be a natural antibiotic and has cured malaria when antibiotics haven't. Maybe this might be a better choice.

Issie-

That is awful. I see WHY you are warning us about antibiotics. I am so sorry that happened to you. I'm glad you are OK now. I agree that "antibiotics aren't always the answer" and people seem to turn to them too readily without being aware of the risks.

However, antibiotics ARE being used as anti-inflammatory medications. I googled to see if my son's ped was "out-to-lunch" and I got over 4 million hits like this: http://www.amazon.com/Antibiotics-Anti-Inf...n/dp/3764359250

Just to see if I had misunderstood, I looked back at my son's last clinic notes from Johns Hopkins and his ped, Dr. Peter Rowe stated: "We have begun trying minocycline for some other patients whose fatigue is otherwise not improving, and I suspect this is working as an anti-inflammatory medication, but cannot be sure of the mechanism. " During our visit, he said that the antibiotics help some patients because their dysautonomia is caused by an underlying unidentified Lyme infection. Others may have a similar infection that we haven't identified and therefore can't test for. He went on to say that the response of his patients to the antibiotic therapy has been overwhelming positive. This is a 5 month trial. We have seen some improvement. I suspect we may know the extent of the improvement when we take the antibiotics away. Mack will either dramatically worsen- which will give us a clue OR he will remain the same in which case we will obviously abort the antibiotic therapy. I know it is a reach, but we are very happy to have such a supportive ANS doctor who is willing to allow Mack to try various therapies in an attempt to heal him. As I stated above, he is also taking high doses of probiotics separately from his antibiotics and undergoing regular blood work during this trial.

Antibiotics are not without risk as you know all too well and I don't advocate them for everyone with dysautonomia. This is a calculated risk that we are taking to try to heal our young son after many other failed therapies. Thanks for sharing your cautionary tale. We needed a reminder of what could happen.

Julie

[Aquadiva]

I'm no expert on this subject but I have to comment on this because of my past history. Antibiotics, to my knowledge, are not for inflammation. NSAIDS are for that. Because of being given too many antibiotics, I developed ulcerative colitis. This is severe ulcers, bleeding and inflamation of the colon. I had to go to the bathroom every 5 minutes and it became the dry heaves (only in the opposite end.) The doctor said that most people die within 2 days of having it as bad as I did. It causes a severe imbalance of the intestional flora (good bacterria). When this happened due to the antibiotics, I had to do chemo therapy twice, to kill all the bad bacteria that the antibiotics caused. I nearly DIED. LITERALLY!!!!!!! It took me years to get the good bacteria balanced and to heal up my colon. I had terrible cramping and spasms and that lasted for years. It scares me that someone would stay on antibiotics thinking they are helping themselves. In my case ---everything got worse.

One way to get the good bacteria back is the probiotics. Also Kefeir is easy to drink and taste good. Normally, for antibiotics to work, you wouldn't take them at the same time as the probiotics. You could try Collidol Silver, it's supposed to kill bad bacteria. This is controversal though. I know someone who swears they are still alive when issued a death sentence to cancer. But, then there is that guy who turned BLUE from it too.

I hope you really consider what happened to me. Antibiotics aren't always the answer. When you really need them for a life threatening situation, you may have made yourself resistant and then they won't work.

One other thing I've read and heard about is -- Olive Leaf. It is supposed to be a natural antibiotic and has cured malaria when antibiotics haven't. Maybe this might be a better choice.

Wow, it is unbelievable what you went through! I am curious as to what antibiotics you were on and for how long before you got to that point.

Also, not to be disrespectful, but you indeed did have "colits" by the sounds of it, but not ulcerative colitis. Ulcerative colitis is an inflammatory bowel disease that is an autoimmune disease and not caused by antibiotics or bacteria. Often times people get them confused. Colitis is curable, where ulcerative colitis is not.

I have known of many people to be put on antibiotics for ulcerative colitis and Crohn's Disease to try to help control the inflammation. It isn't the first line of treatment used, however.

I agree that we need to be very carefule with antibiotics, but on the other hand, they have saved many lives. It can be in the manner they are used, as you stated, that can really cause problems. I sure hope that what happend to you is a very rare thing as it sounds very scary and obviously life threatening. SO happy you were able to get things under control, but it sounds like it was a long, rough road.

[spaceorca]

My son is another one with pandysautonomia and Crohn's disease, but low CRP and sed rates. The doctors all assume that his conditions are caused by inflammation, but those markers rarely are elevated. I think, like so many other tests, they must be underinclusive.

Antibiotics are such a double-edged sword. They're life saving in many circumstances, and they sometimes have helped patients with Crohn's and many other inflammatory diseases. But they can also cause neuropathy, which in turn can produce autonomic problems. My son's neurologist has marked his chart so that he will not receive metronidazole (flagyl) again. He's had that several times after bowel surgery or intestinal infections, but it has caused autonomic neuropathy in some IBD patients. So the neurologist felt it wasn't worth the risk--although my son can take other antibiotics as necessary.

[ramakentesh]

Get this - my C-reactive protein was low when i had active inflammation of my back and high when i felt quite well...

[scarfgirl]

During our visit, he said that the antibiotics help some patients because their dysautonomia is caused by an underlying unidentified Lyme infection. Others may have a similar infection that we haven't identified and therefore can't test for. He went on to say that the response of his patients to the antibiotic therapy has been overwhelming positive.

As I've probably said before, I don't buy the Lyme disease bit, but I am interested in further results from this guy's tests with antibiotic therapy. Has he published anything yet about his theories or findings?

Inflammation is something I've wondered about as well. I've always had bad allergies, and just as allergies are my body inappropriately reacting to stimuli, I've often wondered if POTS wasn't the result of a similar overreaction of sorts, and that allergies weren't another symptom instead of a separate issue. Especially since I don't seem to be allergic to specific things. Is there any way to go about testing these theories? I made a post earlier about tests I needed, and testing my inflammation response is something I'm interested in. I can't concentrate well enough to get through all the replies, much less read the article itself to find my answer, so if someone could make a very simple response along the lines of "Stacy, you need to have X examined or try taking Y and see if it helps" or "Stacy, inflammation is too intricate a bodily response for a single test to tell you much" I'd appreciate it.

[Aquadiva]

My son is another one with pandysautonomia and Crohn's disease, but low CRP and sed rates. The doctors all assume that his conditions are caused by inflammation, but those markers rarely are elevated. I think, like so many other tests, they must be underinclusive.

Antibiotics are such a double-edged sword. They're life saving in many circumstances, and they sometimes have helped patients with Crohn's and many other inflammatory diseases. But they can also cause neuropathy, which in turn can produce autonomic problems. My son's neurologist has marked his chart so that he will not receive metronidazole (flagyl) again. He's had that several times after bowel surgery or intestinal infections, but it has caused autonomic neuropathy in some IBD patients. So the neurologist felt it wasn't worth the risk--although my son can take other antibiotics as necessary.

Spaceorca, I am curious, what exactly are the symptoms of autonomic neuropathy? And, is it an immediate side effect of flagyl?

[juliegee]

"As I've probably said before, I don't buy the Lyme disease bit, but I am interested in further results from this guy's tests with antibiotic therapy. Has he published anything yet about his theories or findings?

Inflammation is something I've wondered about as well. I've always had bad allergies, and just as allergies are my body inappropriately reacting to stimuli, I've often wondered if POTS wasn't the result of a similar overreaction of sorts, and that allergies weren't another symptom instead of a separate issue. Especially since I don't seem to be allergic to specific things. Is there any way to go about testing these theories? I made a post earlier about tests I needed, and testing my inflammation response is something I'm interested in. I can't concentrate well enough to get through all the replies, much less read the article itself to find my answer, so if someone could make a very simple response along the lines of "Stacy, you need to have X examined or try taking Y and see if it helps" or "Stacy, inflammation is too intricate a bodily response for a single test to tell you much" I'd appreciate it."

________________________________________________________________________________

I wish I had an easy answer for you & all of us Sorry no such luck! You are entitled to your skepticism re. the Lyme connection to dysautonomia, BUT many here have had great autonomic improvement after treating an underlying (unknown) Lyme infection. That connection is well documented. Unfortunately, I don't think my son is among them. He's had antibiotics for almost 5 months now & no dramatic improvement. (Sigh) He may get much worse when we take him off & that will tell us something...

I'm also officially allergic to nothing, but have severe allergy symptoms. I agree with your theory. My body also seems to over-react to some stimuli with an inappropriate allergic response. If you feel up to it, check out Mast Cell Activation Disorder/MCAD- that's how my docs explain the extreme allergy thing. I learned about it at The Mastocytosis Society website: www.tmsforacure.org

Julie